561710698-10-12-2022-17-CC-ATOO-CKXVDL-20221107152052

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 561710698
Report Date: 10/12/2022
Date Signed: 10/12/2022 01:23:42 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/25/2022 and conducted by Evaluator Rona Chavez

COMPLAINT CONTROL NUMBER: 17-CC-20220825104915

FACILITY NAME:	HOLY CROSS FAMILY PRE-SCHOOL AND DAY CARE		FACILITY NUMBER:	561710698
ADMINISTRATOR:	SAMANTHA JULIAS		FACILITY TYPE:	840
ADDRESS:	1212 MARICOPA HIGHWAY		TELEPHONE:	(805) 646-8121
CITY:	OJAI	STATE: CA	ZIP CODE:	93023
CAPACITY:	35	CENSUS: 0	DATE:	10/12/2022
		UNANNOUNCED	TIME BEGAN:	11:48 AM
MET WITH:	Marisa Gruber		TIME COMPLETED:	01:39 PM

ALLEGATION(S):

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Care and Supervision

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rona Chavez made an unannounced visit to conclude a complaint investigation. LPA met with Assistant Director Marisa Gruber and together toured the facility inside and out. During the inspection there were 0 children in care.

Allegation stated that facility staff were not providing adequate supervision to children in care. The investigation included two (2) unannounced inspections, interviews with parents, and Director.
Over the course of interviews, parents reported witnessing children on the yard and staff not in the immediate area and looking at their phones. Director reported receiving complaints regarding specific staff named in the interviews. Director stated that at the time the parent reported the staff to her she immediately addressed it with the staff involved. The allegation regarding lack of supervision is substantiated.

Cont on 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Rona Chavez	TELEPHONE: (424) 299-1480
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 17-CC-20220825104915

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: HOLY CROSS FAMILY PRE-SCHOOL AND DAY CARE	FACILITY NUMBER: 561710698
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/12/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/12/2022 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs.(1) No child(ren) shall be left without the supervision of a teacher at any time... This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Facility willl provide a written statement of how the facility will ensure that visual supervision will be met and submit to LPA via email rona.chavez@dss.ca.gov.
	8 9 10 11 12 13 14	Based on LPAs interviews with Director and parents, it was confirmed that an incident occured where staff were not providing supervision to children in care. This poses an immediate risk to the health and safety of the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Rona Chavez	TELEPHONE: (424) 299-1480
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 17-CC-20220825104915

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: HOLY CROSS FAMILY PRE-SCHOOL AND DAY CARE	FACILITY NUMBER: 561710698
	VISIT DATE: 10/12/2022

NARRATIVE

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The allegation regarding reporting requirements is substantiated a Type B deficiency (Title 22 California Code of Regulations 101229(a)(1)) is being cited on the attached LIC 9099-D.

Assistant Director and LPA discussed Plan of Correction (POC) and facility willl provide a written statement of how the facility will ensure that visual supervision will be met and submit to LPA via email rona.chavez@dss.ca.gov.

During the Exit interview with Assistant Director Marisa Gruber a copy of the report, appeal rights and Notice of Site Visit was provided.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Rona Chavez	TELEPHONE: (424) 299-1480
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

LIC9099 (FAS) - (06/04)

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